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Tips and Tricks when Doing a Literature Review Family Medicine Resident Project

When doing a literature review, you need to adhere to some conventions. Before you start you may find it helpful to consult with a university/hospital librarian on how best to access resources for the literature review.

  1. Research question has to be relevant to family medicine
  2. Assess the level of evidence of the studies you are reviewing (see Levels of Evidence below)
  3. Focus of literature review (see Sample Paper Outline below)
  4. Create a table that is the focus of your review (see Sample Table below)
  5. Do not repeat word for word what you have in the tables in the text
  6. Use the same outline as a regular scientific study
    1. Introduction: why did you want to do this project
    2. Background: set up the research question with some general literature
      1. Finish the section with a clear research question
    3. Methods need to include the following:
      1. Search terms
      2. Inclusion and exclusion criteria
      3. Grey literature, if used
      4. Data sets used - e.g. PubMed
      5. Number of articles pulled and ultimately reviewed
  7. In the discussion describe the strengths and weaknesses of each article and synthesize the data. Use headings to help the reader. Answer the research question.
  8. In the conclusion pull it all together, no new information should be added
  9. Acknowledgments: supervisor and others that may have helped you
  10. Use a standard bibliography format and do not mix bibliography styles

Levels of Evidence

Level of Evidence Study Design Definition How does sleeping with a bottle of juice versus a bottle of water affect children’s dental hygiene?
1 Randomized Control Trials (RCTs) RCTs are considered the most reliable form of scientific evidence.   They involve the random assignment of participants to interventions and controls. A group of children are randomly selected from the general population (each child has the same likelihood of being selected as all the others). This group is then randomly divided into two groups (A and B). Again, each child has an equal chance of being placed in either group. Group A is given a bottle of juice to sleep with at night. Group B is given a bottle of water to sleep with at night. The effect on the children’s teeth is monitored for a set amount of time. 
2 Cohort Studies A Cohort Study is a study in which participants who presently have a certain condition and/or receive a particular treatment are followed over time. They are then compared with another group who are not affected by the condition. A group of children who have poor dental health are followed across time. The habit of sleeping with a bottle of juice or water of the poor dental health group is compared to the sleep habits of a control group.
Ecological/ Epidemiological Studies Ecological studies look for associations between the occurrence of disease and exposure to known or suspected causes. The unit of observation is the population or community and may be defined in various ways. Children with poor dental health are identified. Then correlations are made between (a) sleeping with a bottle of juice and dental health and (b) sleeping with a bottle of water and dental health.
3 Case-Controlled Studies Case-control studies are a frequently used in epidemiological studies. Case-control studies compare participants who have a specific condition with participants who do not have the condition. Otherwise similar in order to identify factors that may contribute to the condition of interest. Comparing children with poor dental health, with those who have good dental health who are the same age, ethnicity, socio-economic background, number of dental check-ups, etc.
Non-Randomized Control Trials The participants and interventions are not randomly assigned. The first 50 to volunteer are instructed to have their child sleep with a bottle of juice, with the last 50 volunteers are instructed to have their child sleep with a bottle of water.
4 Case-Series A number of individual cases of a particular condition are identified and followed individually over time. Ten cases of poor dental hygiene in children are identified and intensely followed for a set amount of time.
5 Expert Opinion The opinion of a professional who is considered an expert in their field. The advice/opinion of a dentist who specializes in children’s oral health and who has worked in the field for a long period of time.

Sample Paper Outline

  • Introduction (½ to one page)
  • Background (one page)
    • Obesity
    • Why school-based programs?
  • Research Question: What are the features of a successful school based health program?
  • Methods (½ to one page)
  • Results (four to five pages)
    • Features of successful programs
      • Peer-led
      • Collaborative – community
      • Dedicated school health coordinators
      • Incorporates national/provincial/regional guidelines
      • Parents as integral part of program and source of support for children
      • Role of family doctors in the school-based health program model
      • Gender and other subgroup analysis
  • Discussion (four to five pages)
  • Conclusion (one page)
  • Acknowledgement
  • Bibliography
  • Tables: the table becomes the central piece of your review. Do not repeat what is in the table in the text, but describe it in general terms.
Dr. Kappagantula provided permission to use her resident project as a sample project outline and literature review table.

Sample Table

Author Design n Variables Results Limitations
Bjelland et al. RCT 1465 Sugared beverage intake, sedentary behaviour Preventive initiatives more effective in girls, need to study gender subgroups Crude estimates of sedentary behaviours, sampling bias, social desirability in data
Brown T, Summerbell C. Literature Review 38 Weight outcome School based interventions may have benefit but inconsistent, may be short-term, girls/younger children have more benefit, physical activity must be combined with diet interventions Heterogeneity of studies evaluated, therefore difficult to generalize any findings.
Bryn Austin S et al. Qualitative 9 Effectiveness of School Health Index, Role of external facilitator Presence of external facilitator influenced effectiveness of SHI and ability of schools to implement health promotion initiatives Most schools in one geographical location (New England), reliance on self-reported data, did not include an objective data source
Card A, Doyle E. Qualitative 40 Effectiveness of School Health Coordinator in implementing health promotion strategies in Nfld. School health coordinator can change the approach of health promotion in schools to involve social, environmental as well as physiological health determinants Vague descriptors regarding effectiveness of school health coordinators, results very preliminary in nature
Crawford PB et al. Position paper n/a n/a Using a bioethics framework further justifies the promotion of nutritional health through schools n/a
Groft JN et al. Survey 288 Identify areas of concern and interest regarding health practices of rural adolescents Weight management, nutritional concerns, physical activity were all expressed as health goals, and student involvement leads to creation of successful strategies Use of existing adolescent health survey, inability to compare results. Only one school studied therefore results not generalizable, rely on self-reporting of students).